Menopause or Peri-Menopause?

Are you experiencing Menopausal Symptoms?

Many people think that the menopause causes many unpleasant and disruptive symptoms for women. However, It is actually the transition phase to menopause, called the perimenopause, when most women experience the most unpleasant symptoms of hot flushes, night sweats and irregular periods. 


The most common symptoms of the peri-menopause  are:

  • Irregular periods
  • Hot flushes & night sweats
  • Trouble sleeping
  • Vaginal dryness
  • Reduced sex drive (low libido)
  • Mood swings

Many women will experience other symptoms and do not realise it’s related to the perimenopause, these include:

  • Memory lapses, trouble concentrating and ‘brain fog’
  • Anxiety and depression
  • Fatigue and tiredness
  • Headaches, vertigo, and dizzy spells
  • Breast soreness
  • Burning mouth and gum problems
  • Joint pain, muscle tension, electric shocks, and tingling extremities
  • Digestive issues and bloating
  • Hair loss, dry, itchy skin, and brittle nails
  • Weight gain
  • Irregular heartbeat

Here are a few examples of the physiological process taking place behind the symptoms.



As progesterone levels begin fluctuating in the early stages of the transition to the menopause, periods will become irregular. You may find your periods:

  • Last longer or may only last a couple of days
  • May be heavier or lighter than normal
  • Are more frequent – every 2 weeks - or less frequent

Some months you may not notice any changes, and other months you may notice that your periods are different. It is worth keeping a diary of your periods to see if they are changing as this is a clear indication that you may be entering the perimenopause.



Hot flushes and night sweats are the same, the only difference is that night sweats are hot flushes that happen at night!

Hot flushes and night sweats are caused by declining oestrogen levels, this impacts your brains' ability to regulate body temperature.  Your body thinks it is overheating when it isn’t and your brain triggers the body to cool down by sweating and increasing blood flow through the skin’s blood vessels which causes the flush.

Hot flushes and night sweats are common menopausal symptoms and can vary in severity and duration. For about 20% of women, they can be quite severe and cause a lot of distress impacting work, sleep, and overall quality of life.  However, for most women going through the menopause, they only occur occasionally.

Experiencing hot flushes and night sweats can also increase body odour.  In addition, symptoms such as anxiety create sweat produced in the apocrine glands. Anxiety sweat is fatty and breeds and feeds on bacteria which creates a more pungent smell.



During the perimenopause, levels of the hormones oestrogen and progesterone fluctuate and gradually decline as a woman nears the menopause.  These hormone changes can have a drastic impact on sleep.

“Estimates are that between 40 and 60 per cent of women will be affected by insomnia or another sleep disruption,” says Dr Heather Currie, founder of Menopause Matters.

Oestrogen is important for managing the level of magnesium in the body.  Magnesium is used by the body to help muscles relax and low levels can make it more difficult to fall asleep.  In addition, falling oestrogen levels cause hot flushes and night sweats which can also impact the natural sleep cycle.

There are oestrogen receptors all over our bodies including joints, and as oestrogen levels fall, this can cause joint inflammation.  In addition, lower oestrogen levels can cause a rise in the stress hormone cortisol which can make us more stressed and anxious.  This, in turn, can cause muscle tension.  Raised cortisol levels can also increase our sensitivity to pain.

Other perimenopause symptoms such as night sweats, joint aches, and the need to urinate more frequently all impact a good night’s sleep, resulting in fatigue and tiredness during the day.

Tiredness and fatigue have an impact on being able to carry out and cope with day to day tasks and life events.  This can result in stress which in turn increases levels of the stress hormone cortisol in the body – raised cortisol levels, particularly at night will impact your ability to fall asleep and stay asleep.

In addition, low levels of oestrogen can also result in a feeling of fatigue.



Research indicated that 61% of perimenopausal women experienced low mood.

Sleep problems caused by perimenopause symptoms such as night sweats, lead to sleep deprivation which in turn can cause anxiety and/or depression.  

"Neuroscientists have found that sleep deprivation fires up areas of the brain associated with emotional processing. The resulting pattern mimics the abnormal neural activity seen in anxiety disorders" according to,

In addition to poor sleep quality, anxiety, and depression, along with low mood are associated with low levels of serotonin.  Oestrogen influences the production and breakdown of serotonin, so lower levels of oestrogen will impact serotonin levels in women going through the menopause.



It can be difficult to know what is going on in your body as you transition through to the menopause.  Fluctuations in oestrogen and progesterone have an impact on all aspects of your mind and body, lasting anywhere between 4-8 years.

This can leave you feeling confused, overwhelmed and out of control – and just not feeling like your normal self.

The first step is to understand whether the symptoms you are experiencing are due to the perimenopause.  One way to do this is by measuring and tracking your hormone levels over time.

Our perimenopause check is a simple finger prick blood test which checks the key hormones associated with the menopause. By tracking hormone changes over time, you will be able to establish if you are perimenopausal.  

All our tests are carried out by UKAS accredited labs here in the UK and results are reviewed by our Advanced Nurse Practitioner.

Once you understand whether your symptoms are being caused by hormone fluctuations, you will be able to make the necessary lifestyle changes and live well with the menopause.

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